The U.S. Labor Department filed a lawsuit against a subsidiary of UnitedHealth Group, alleging that various claims were wrongfully denied, and the decision to deny the claims was based on diagnosis codes and not medical necessity. These claims include payments to healthcare providers for ER services and urinary drug screenings. The U.S. Labor Department states that UnitedHealth group denied thousands of claims that were medically necessary, and in the denials, UnitedHealth group did not include required information and details about an appeal process for patients. The department also claims that the company denied all urinary drug screenings, and the denial of all these claims negatively impacted patients and healthcare providers.
See "U.S. Labor Department claims that UnitedHealth wrongfully denied thousands of claims, files lawsuit", Christopher Snowbeck, Star Tribune, August 2, 2023